IMAGINE ORTHODONTIC STUDIO PLLC (NPI# 1700411857) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700411857 |
| Entity Type | Organization |
| Organization Name | IMAGINE ORTHODONTIC STUDIO PLLC |
| Practice Address |
3595 S Florida Ave Lakeland FL 33803-4860 |
| Practice Telephone | 7277438307 |
| Enumeration Date | 2020-03-10 |
| Last Update Date | 2020-05-11 |
| Authorized Official Name | PAIYAL POPAT (OWNER) |
| Authorized Official Telephone | 4077585424 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers |
| Street Address |
3595 S FLORIDA AVE |
| City | LAKELAND |
| State | FL |
| Zip Code | 33803-4860 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861964819 | Steven P Agelidis | Counselor | 2020 S. Florida Ave, Suite 207, Lakeland, FL 33803 | 2018-12-31 |
| 1902316201 | Kesara Mai Ngam | Massage Therapist | 117 West Oak Drive, Lakeland, FL 33803 | 2017-10-02 |
| 1396260618 | Suncoast Behavioral Solutions, LLC | Behavioral Analyst | 1920 E Edgewood Dr Apt A8, Lakeland, FL 33803 | 2017-08-08 |
| 1316484413 | Daniel Jacob Stahl | Behavior Technician | 145 East Edgewood Drive, Lakeland, FL 33803 | 2017-01-26 |
| 1780037002 | Shelley Stettinius | Behavioral Analyst | 145 East Edgewood Dr, Lakeland, FL 33803 | 2016-07-21 |
| 1396106654 | Highlands Occupational Therapy, Inc | Occupational Therapist | 2000 East Edgewood Drive, Suite 114, Lakeland, FL 33803 | 2016-03-15 |
| 1003289570 | Jayna Dinsmore | Physical Therapy Assistant | 321 Imperial Blvd, D38, Lakeland, FL 33803 | 2015-11-05 |
| 1093187429 | Healthstat Wellness Polk-lakeland | Preventive Medicine | 3215 Winter Lake Road, Lakeland, FL 33803 | 2015-10-26 |
| 1962812545 | Florida Presbyterian Homes, Inc | Nursing Facility/Intermediate Care Facility | 901 Lakeside Avenue, Lakeland, FL 33803 | 2014-05-05 |
| 1710316336 | Trinity Endodontics | Health Maintenance Organization | 1602 S. Florida Ave, Ste #1, Lakeland, FL 33803 | 2013-11-04 |
| Find all providers in zip 33803 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063618759 | Keith Hilliard Dmd Pa | Dentist | 330 E Highland Drive, Lakeland, FL 33813-1727 | 2007-06-21 |
| 1891830071 | Alan D Shoopak Dmd Orthodontic Group Vii LLC | Dentist | 4740 Cleveland Heights Blvd, Suite 4, Lakeland, FL 33813-2187 | 2007-02-21 |
| 1477029031 | Jonathan Scott | Dentist | 5110 S Lakeland Dr, Lakeland, FL 33813-2500 | 2018-10-22 |
| 1164881835 | Children and Teen Ortho Group of Florida | Dentist | 3885 S Florida Ave, Lakeland, FL 33813 | 2016-02-23 |
| 1922378785 | Andrew Dietrich | Dentist | 330 E Highland Dr, Lakeland, FL 33813-1727 | 2012-01-10 |
| 1235346149 | Jorge Parajon, Dds, Ms, Pa | Dentist | 4238 Us Highway 98 N, Lakeland, FL 33809-3819 | 2007-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326647215 | Matthew Inaba Pickron | Dentist | 6476 Lake Worth Rd, Lake Worth, FL 33463 | 2020-10-21 |
| 1366056848 | Brandon Lee Zipper | Dentist | 901 N Congress Ave Ste 107, Boynton Beach, FL 33426-3316 | 2020-09-02 |
| 1851903298 | Ocoee Dental & Orthodontics, P.a. | Dentist | 2910 Maguire Rd Ste 1005, Ocoee, FL 34761-4742 | 2020-08-18 |
| 1952933541 | Katherine Kapernaros | Dentist | 1395 Center Dr Rm D7-35, Gainesville, FL 32610-3006 | 2020-02-11 |
| 1609408574 | Ortho 99 Plus 1 | Dentist | 7410 Merrill Road, Suite 2, Jacksonville, FL 32277 | 2020-02-10 |
| 1538709514 | Gardner Orthodontics | Dentist | 518 Hollyberry Lane, Suite 105, Orange Park, FL 32065 | 2020-01-08 |
| 1700421344 | Lindsay A Ringdahl Dmd Ms Pa | Dentist | 85 Weston Rd Unit 102, Weston, FL 33326-1158 | 2019-11-07 |
| 1942844493 | Daniel R Camacho | Dentist | 4330 Sheridan St Ste 201a, Hollywood, FL 33021-1406 | 2019-10-28 |
| 1982247102 | Thebis A. Franceschi | Dentist | 813 Delmar Way Apt 116, Delray Beach, FL 33483-3366 | 2019-10-21 |
| 1730736174 | Integrity Dental, LLC | Dentist | 5100 Tamiami Trl N Ste 201, Naples, FL 34103-2810 | 2019-08-21 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on IMAGINE ORTHODONTIC STUDIO PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.